Impacto da estratégia PAL-GARD/OMS em área piloto da região metropolitana de Belo Horizonte

Abstract

Respiratory diseases are among the diseases with the highest morbidity and mortality in the world.According to the World Health Organization (WHO) acute respiratory diseases (ARI) occupy the third place in the classification of the conditions that most lead to death and chronic obstructive pulmonary disease (COPD), occupies the fourth place. This thesis describes the feasibility and implementation evaluation of the Practical Approach to Lung Health - Global Alliance Against Chronic Respiratory Disease - PAL-GARD in the Metropolitan Region of Belo Horizonte. The objective was to test and validate the PAL-GARD Strategy as a tool for the diagnosis of respiratory diseases through standardized training of general practitioners (GPs) of Primary Health Care (PHC) and then to assess the concordance of the diagnosis between GPs and pulmonologists. The study was carried out in two phases, involving the same groups: the PAL-GARD group, who received the training (intervention group) and the control group, who acted without this intervention. Thirty GPs treated 536 cases being 358 cases and 178 controls. There was an improvement in the diagnostic agreement between the PAL GARD group and pulmonologists in relation to asthma (0.546 to 0.638), tuberculosis (0.393 to 0.655) and IRAS (0.577 to 0.584). However, there was a reduction in concordance in cases of COPD (0.430 to 0.284). The PAL-GARD Strategy in Brazil tested protocols for local application. It demonstrated an improvement in the diagnostic agreement between GPs and pulmonologists after training in PAL-GARD protocols.